Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Brief Communication
  • Published:

Clinical Research

Health-enhancing physical activity in obesity management: the need to (seriously) go beyond weight loss

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

There are many false hopes around the impact of physical activity and exercise in obesity management, especially regarding weight loss. Narrowly focusing on weight loss only leads to disappointment for patients and practitioners. Indeed, in persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight and fat loss compared to the absence of training. However the magnitude of this effect remains modest, amounting to only 2–3 kg additional weight or fat loss on average. We therefore argue that this conversation needs to be re-oriented towards the many potential health benefits of physical activity that can be seen beyond weight loss. Exercise training has been shown to improve the cardiometabolic risk profile by effects including decreasing abdominal visceral fat and improving insulin sensitivity. Aerobic, as well as combined aerobic and resistance (i.e. strength) training, increase cardiorespiratory fitness, a major risk factor for ill health. Resistance training improves muscle strength, another major component of physical fitness, even in the absence of a significant change in muscle mass. Beyond body mass loss, recognizing the broad value of physical activity/exercise in improving health and quality of life of people with obesity is a crucial perspective shift.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Multiple beneficial effects of exercise training/physical activity beyond weight loss.

Similar content being viewed by others

References

  1. WHO. WHO Guidelines on physical activity and sedentary behavior. Geneva: World Health Organization; 2020. WHO Physical activity guidelines 2020.

    Google Scholar 

  2. Oppert J-M, Bellicha A, van Baak MA, Battista F, Beaulieu K, Blundell JE, et al. Exercise training in the management of overweight and obesity in adults: Synthesis of the evidence and recommendations from the European Association for the Study of Obesity Physical Activity Working Group. Obes Rev. 2021;22:e13273.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bellicha A, van Baak MA, Battista F, Beaulieu K, Blundell JE, Busetto L, et al. Effect of exercise training on weight loss, body composition changes, and weight maintenance in adults with overweight or obesity: An overview of 12 systematic reviews and 149 studies. Obes Rev. 2021;22:e13256.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bellicha A, van Baak MA, Battista F, Beaulieu K, Blundell JE, Busetto L, et al. Effect of exercise training before and after bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2021;22:e13296.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Allison DB, Bier DM, Locher JL. Measurement rigor is not a substitute for design rigor in causal inference: increased physical activity does cause (modest) weight loss. Int J Obes. 2023;47:3–4.

    Article  Google Scholar 

  6. Pontzer H. Exercise is essential for health but a poor tool for weight loss: a reply to Allison and colleagues. Int J Obes (Lond). 2023;47:98–9.

    Article  PubMed  Google Scholar 

  7. Thomas DM, Bouchard C, Church T, Slentz C, Kraus WE, Redman LM, et al. Why do individuals not lose more weight from an exercise intervention at a defined dose? An energy balance analysis. Obes Rev. 2012;13:835–47.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  8. Della Guardia L, Shin AC. Obesity-induced tissue alterations resist weight loss: A mechanistic review. Diabetes Obes Metab. 2024;26:3045–57.

    Article  PubMed  Google Scholar 

  9. Su L, Fu J, Sun S, Zhao G, Cheng W, Dou C, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: A meta-analysis. PLoS One. 2019;14:e0210644.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Dhurandhar EJ, Kaiser KA, Dawson JA, Alcorn AS, Keating KD, Allison DB. Predicting adult weight change in the real world: a systematic review and meta-analysis accounting for compensatory changes in energy intake or expenditure. Int J Obes. 2015;39:1181–7.

    Article  CAS  Google Scholar 

  11. Stubbs RJ, Sepp A, Hughes DA, Johnstone AM, King N, Horgan G, et al. The effect of graded levels of exercise on energy intake and balance in free-living women. Int J Obes Relat Metab Disord. 2002;26:866–9.

    Article  PubMed  CAS  Google Scholar 

  12. Beaulieu K, Hopkins M, Blundell J, Finlayson G. Homeostatic and non-homeostatic appetite control along the spectrum of physical activity levels: An updated perspective. Physiol Behav. 2018;192:23–9.

    Article  PubMed  CAS  Google Scholar 

  13. Careau V, Halsey LG, Pontzer H, Ainslie PN, Andersen LF, Anderson LJ, et al. Energy compensation and adiposity in humans. Curr Biol. 2021;31:4659–66. e2

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  14. King NA, Hopkins M, Caudwell P, Stubbs RJ, Blundell JE. Individual variability following 12 weeks of supervised exercise: identification and characterization of compensation for exercise-induced weight loss. Int J Obes (Lond). 2008;32:177–84.

    Article  PubMed  CAS  Google Scholar 

  15. Gepner Y, Shelef I, Schwarzfuchs D, Zelicha H, Tene L, Yaskolka Meir A, et al. Effect of distinct lifestyle interventions on mobilization of fat storage pools: CENTRAL Magnetic Resonance Imaging Randomized Controlled Trial. Circulation. 2018;137:1143–57.

    Article  PubMed  Google Scholar 

  16. Battista F, Ermolao A, van Baak MA, Beaulieu K, Blundell JE, Busetto L, et al. Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis. Obes Rev. 2021;22:e13269.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  17. Laaksonen DE, Lindström J, Lakka TA, Eriksson JG, Niskanen L, Wikström K, et al. Physical activity in the prevention of type 2 diabetes: the Finnish. diabetes Prev study Diabetes 2005;54:158–65.

    CAS  Google Scholar 

  18. PAGAC. Physical Activity Guidelines Advisory Comittee Report. Washington, DC: US Department of Health and Human Services; 2018.

    Google Scholar 

  19. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N. Engl J Med. 2002;346:793–801.

    Article  PubMed  Google Scholar 

  20. Stenholm S, Mehta NK, Elo IT, Heliövaara M, Koskinen S, Aromaa A. Obesity and muscle strength as long-term determinants of all-cause mortality–a 33-year follow-up of the Mini-Finland Health Examination Survey. Int J Obes (Lond). 2014;38:1126–32.

    Article  PubMed  CAS  Google Scholar 

  21. van Baak MA, Pramono A, Battista F, Beaulieu K, Blundell JE, Busetto L, et al. Effect of different types of regular exercise on physical fitness in adults with overweight or obesity: Systematic review and meta-analyses. Obes Rev. 2021;22:e13239.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Davis ME, Blake C, Perrotta C, Cunningham C, O’Donoghue G. Impact of training modes on fitness and body composition in women with obesity: A systematic review and meta-analysis. Obesity. 2022;30:300–19.

    Article  PubMed  CAS  Google Scholar 

  23. Oppert JM, Ciangura C, Bellicha A. Physical activity and exercise for weight loss and maintenance in people living with obesity. Rev Endocr Metab Disord. 2023;24:937–49.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutrition, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne Université, CRNH-Ile de France, F-75013, Paris, France

    Jean-Michel Oppert & Cécile Ciangura

  2. Université Sorbonne Paris Nord and Université Paris Cité, INSERM, INRAE, CNAM, Center of Research in Epidemiology and StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), F-93017, Bobigny, France

    Jean-Michel Oppert & Alice Bellicha

Authors
  1. Jean-Michel Oppert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cécile Ciangura
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alice Bellicha
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JMO, CC and AB conceived the paper. JMO drafted the manuscript. All authors contributed to intellectual content and to the final version of the manuscript.

Corresponding author

Correspondence to Jean-Michel Oppert.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oppert, JM., Ciangura, C. & Bellicha, A. Health-enhancing physical activity in obesity management: the need to (seriously) go beyond weight loss. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01632-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41366-024-01632-1

Search

Advanced search

Quick links